{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T03:02:28Z","timestamp":1791946948647,"version":"4.3.4"},"reference-count":40,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2013,12,23]],"date-time":"2013-12-23T00:00:00Z","timestamp":1387756800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2014,6]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>This multicentre observational study evaluated the feasibility, efficacy and toxicity of antifungal combination therapy (combo) as treatment of proven or probable invasive fungal diseases (<jats:styled-content style=\"fixed-case\">IFD<\/jats:styled-content>s) in patients with haematological malignancies. Between January 2005 and January 2010, 84 cases of <jats:styled-content style=\"fixed-case\">IFD<\/jats:styled-content>s (39 proven and 45 probable) treated with combo were collected in 20 Hematological Italian Centres, in patients who underwent chemotherapy or allogeneic haematopoietic stem cell transplantation for haematological diseases. Median age of patients was 34\u00a0years (range 1\u201373) and 37% had less than 18\u00a0years. Acute leukaemia was the most common underlying haematological disease (68\/84; 81%). The phase of treatment was as follows: first induction in 21\/84 (25%), consolidation phase in 18\/84 (21%) and reinduction\/salvage in 45\/84 (54%). The main site of infection was lung with or without other sites. The principal fungal pathogens were as follows: <jats:italic>Aspergillus<\/jats:italic> sp. 68 cases (81%), <jats:italic>Candida<\/jats:italic> sp. six cases (8%), <jats:italic>Zygomycetes<\/jats:italic> four cases (5%) and <jats:italic>Fusarium<\/jats:italic> sp. four cases (5%). The most used combo was caspofungin+voriconazole 35\/84 (42%), caspofungin\u00a0+\u00a0liposomal amphotericin B (L\u2010AmB) 20\/84 (24%) and L\u2010AmB+voriconazole 15\/84 (18%). The median duration of combo was 19\u00a0days (range 3\u2013180). The overall response rate (<jats:styled-content style=\"fixed-case\">ORR<\/jats:styled-content>) was 73% (61\/84 responders) without significant differences between the combo regimens. The most important factor that significantly influenced the response was granulocyte (<jats:styled-content style=\"fixed-case\">PMN<\/jats:styled-content>) recovery (<jats:italic>P<\/jats:italic> 0.009). Only one patient discontinued therapy (voriconazole\u2010related neurotoxicity) and 22% experienced mild and reversible adverse events (hypokalaemia, <jats:styled-content style=\"fixed-case\">ALT<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">AST<\/jats:styled-content> increase and creatinine increase). The <jats:styled-content style=\"fixed-case\">IFD<\/jats:styled-content>s\u2010attributable mortality was 17%. This study indicates that combo was both well tolerated and effective in haematological patients. The most used combo regimens were caspofungin\u00a0+\u00a0voriconazole (<jats:styled-content style=\"fixed-case\">ORR<\/jats:styled-content> 80%) and caspofungin\u00a0+\u00a0L\u2010AmB (<jats:styled-content style=\"fixed-case\">ORR<\/jats:styled-content> 70%). The <jats:styled-content style=\"fixed-case\">ORR<\/jats:styled-content> was 73% and the mortality <jats:styled-content style=\"fixed-case\">IFD<\/jats:styled-content> related was 17%. <jats:styled-content style=\"fixed-case\">PMN<\/jats:styled-content> recovery during combo predicts a favourable outcome. Clinical Trials Registration: <jats:styled-content style=\"fixed-case\">NCT<\/jats:styled-content>00906633.<\/jats:p>","DOI":"10.1111\/myc.12161","type":"journal-article","created":{"date-parts":[[2013,12,23]],"date-time":"2013-12-23T08:48:49Z","timestamp":1387788529000},"page":"342-350","source":"Crossref","is-referenced-by-count":52,"title":["Multicentre surveillance study on feasibility, safety and efficacy of antifungal combination therapy for proven or probable invasive fungal diseases in haematological patients: the SEIFEM real\u2010life combo study"],"prefix":"10.1111","volume":"57","author":[{"given":"A.","family":"Candoni","sequence":"first","affiliation":[{"name":"Division of Hematology University of Udine Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Caira","sequence":"additional","affiliation":[{"name":"Division of Hematology UCSC Rome 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